It’s well to consider that question here in a week in which a shutdown showdown between congressional Republicans and President Obama does make that scenario possible.

First, of course, the government doesn’t in fact shut down. “Essential services” – which include public safety; Congress, oddly enough; presumably saber-rattling off Libya – will go on. Only “non-essential” federal employees would be furloughed for the duration, since there would be no money appropriated to pay them.

Two shutdowns have happened in recent memory – both the result of what are now considered a vast game of “chicken” between two politicians who are very much still on the public stage, then-President Clinton and then-House Speaker Newt Gingrich. The issues were the same then as now: GOP leaders said that proposed Democratic spending cuts, or rather a slowing in the rate of spending increases, weren’t deep enough to make a difference in the long run; Democratic leaders said that Republican cuts would impact the poor and the sick and the elderly disproportionately while the budget would offer more tax cuts to the rich.

That time, the president won. Gingrich made the big mistake, according to former Republican House Majority Leader Tom Delay, of saying he forced the shutdown because Clinton rudely made him and former Sen. Bob Dole sit at the back of Air Force One. “Cry baby,” read the headlines. “Newt’s tantrum.”

Who’ll blink this time? Time will tell. But for the American people, our interest is not in partisan wrangling but in government efficiency.

That means ignoring the bluster on both sides. The Democratic poppycock usually includes a profound reluctance to consider real cuts to even the growth of government entitlement spending. The Republican balderdash usually includes spending cuts to public broadcasting and Planned Parenthood – which doesn’t add up to even a rounding error in the federal budget.

Tuesday, President Obama rejected a House GOP proposal to cut $12 billion from the budget now in exchange for keeping the government running another week.

The Democratically controlled Senate replied that it already backs a proposal to cut $33 billion from the budget and won’t be held hostage by the Republicans’ tea party wing.

And so it goes.

The one interesting, substantive proposal of the week is for reform of the Medicare and Medicaid health spending that does take up 20percent of the federal budget. To even bring up the subject is mighty brave of Rep. Paul Ryan, R-Wisconsin, chair of the Budget Committee. And no wonder: That one-fifth of the budget provides health care for 45 million Americans, Medicaid for the very poor, Medicare for those over 65. It’s important to remember that before President Johnson signed the Medicare law in 1965, half of America’s senior citizens had no health insurance at all.

Ryan’s proposal would, among other things, create a two-tiered system in which everyone currently under 55 would get a specified amount toward private health coverage once they become Medicare-eligible. In total, it would cut a whopping $5 trillion from federal spending over 10 years.

Now that’s real entitlement reform. It also has precisely zero chance of adoption in the Democratic-controlled Senate. So, its real benefit is in being a conversation-starter. While it won’t ever happen in its current form, it is already forcing the Democrats to work on what they call a bipartisan plan for entitlement reform to reduce the federal deficit.

Both parties continue to mostly ignore the fact that rapidly rising health spending is driven more by out-of-control medical costs than it is by “insurance company greed,” “federal bureaucracy,” “litigation-happy lawyers” or anything else at all. Until Americans get rational about that fact, and are willing to live with fewer tests and lower-tech docs, both our government and personal budgets will spend too much on health care.

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